Background:
Excision of early or non-palpable breast cancers can be challenging. A fine balance between oncological and cosmetic outcomes are important considerations whistle performing breast conserving surgery (BCS). Various studies have reported up to 40% patients undergoing re- excision after initial BCS due to positive resection margins. Inadequate resection margins may have adverse oncological impacts due to local recurrence, whilst re-excision can cause increased mental distress and poor cosmetic outcomes. Aim of this study was to evaluate practice of BCS for breast cancer in our department.

Material and Methods:
A retrospective review of database of patients undergoing BCS for breast cancer from November 2010 till October 2013 was performed. Resection margin <1mm was considered as inadequate for invasive cancer and required re-excision. Various modalities such as, clinical assessment, ultra-sonographic (US) guided skin marking or wire insertion, were used pre-operatively to locate the lesion.

Result:
In total 251 patients underwent BCS during this period. 44(17.5%) patients had re-excision due to inadequate or positive resection margins. Out of 44 patients, 9(20%) had a clinically palpable lump, 14(32%) had US-guided skin marking, whilst 21(48%) had US-guided wire insertion. One patient had double re-excision. 2(4%) patients had mastectomy as a re-excision procedure.

Conclusion:
Our rate of re-excision after BCS for breast cancer seem to be at appropriate level. A very low or high re-excision rate can raise concerns about excessive resection of healthy tissue or inadequate resection margins during initial procedure.